RESUMO
Both anti-glomerular basement membrane (GBM) disease and the anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) are common causes of pulmonary-renal syndrome. Organizing pneumonia (OP), a special pattern of interstitial lung disease, is extremely rare either in AAV or anti-GBM disease. We report an old woman presented with OP on a background of co-presentation with both ANCA and anti-GBM antibodies.
Assuntos
Feminino , Humanos , Anticorpos Anticitoplasma de Neutrófilos , Pneumonia em Organização , Autoanticorpos , Glomerulonefrite , Doença Antimembrana Basal Glomerular , Pneumonia , Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/complicaçõesRESUMO
Este artigo tem como objetivo discutir a reinvençaÌo de territoÌrios das infaÌncias e juventudes perifeÌricas a partir de fotografias e poemas produzidos pelo fotoÌgrafo Leo Silva e pelo poeta Talles Azigon (identificados após a aprovação do artigo) como modo de re-existeÌncia em Fortaleza. SaÌo problematizaçoÌes advindas da realizaçaÌo de uma pesquisa-inter(in)vençaÌo de ethos cartograÌfico, junto a esses jovens, em que as imagens e os poemas emergem como dispositivos luÌdicos na produçaÌo de movimentos contra-hegemoÌnicos frente aÌs "imagens oficiais" historicamente impostas sobre as periferias. Por meio dessas fotografias e poemas, e, portanto, da arte, a reivindicaçaÌo dos territoÌrios retrata e narra infaÌncias e juventudes de periferias de Fortaleza a partir de suas poteÌncias e naÌo de suas precarizaçoÌes. Como experimentaçaÌo, o artigo foi produzido a partir desses poemas e fotografias, aleÌm de contar com as participaçoÌes de (a ser identificado, caso o artigo seja aceito, pois atua como participante da escrita do artigo) e (a ser identificado, caso o artigo seja aceito, pois atua como participante da escrita do artigo) na elaboraçaÌo do texto como um movimento decolonial de (des)habitar a escrita acadeÌmica.
This article aims to discuss the reinvention of territories of peripheral childhoods and youths based on photographs and poems produced by photographer Leo Silva and poet Talles Azigon (identified after acceptance of the article) as a way of re-existing in Fortaleza. These are problematizations arising from the realization of an inter(in)vention research of cartographic ethos, with these young people, in which images and poems emerge as playful devices in the production of counter-hegemonic movements against the "official images" historically imposed on the peripheries. Through these photographs and poems, and, therefore, through art, the claim of territories portrays and narrates childhoods and youths on the outskirts of Fortaleza from their strengths and not from their precariousness. As an experiment, the article was produced from these poems and photographs, in addition to counting on the participation of (to be identified if the article is accepted, as it acts as a participant in the writing of the article) and (to be identified if the article is accepted, as it acts as a participant in the writing of the article) in the elaboration of the text as a decolonial movement (dis)inhabiting academic writing.
Assuntos
Fatores Socioeconômicos , Áreas de Pobreza , Pneumonia em Organização , Arte , Recursos Audiovisuais , Características de Residência , AdolescenteRESUMO
La neumonía organizada es una entidad poco frecuente, caracterizada por la formación de conglomerados fibroblásticos intraalveolares conocidos como cuerpos de Masson, que puede ser criptogénica o secundaria a una respuesta inmunitaria a diversos estímulos, tales como enfermedades hematológicas, autoinmunitarias, exposición a sustancias químicas, fármacos, tóxicos, etc. Detectada y tratada de forma precoz, suele tener una buena respuesta a la corticoterapia, aunque si se diagnostica de forma tardía, la afectación pulmonar puede ser extensa, y, además, si el estímulo antigénico persiste, la respuesta al tratamiento será incompleta. Presentamos el caso clínico de una paciente de 65 años de edad quien hace 18 meses aproximadamente presentó la rotura intracapsular de sus implantes mamarios, 27 años después de su colocación. Con el mismo tiempo de evolución ha desarrollado progresivamente disnea, tos seca y dolor inframamario, habiendo llegado al diagnóstico de neumonía organizada bilateral difusa, asociada a dicha rotura de implantes.
Organizing pneumonia is a rare entity, characterized by the formation of intraalveolar fibroblastic conglomerates known as Masson bodies, which may be cryptogenic or secondary to an immune response to various stimuli, such as hematological, autoimmune diseases, exposure to chemical substances, drugs, toxics, etc. If it is detected and treated early, it usually has a good response to corticosteroid therapy, although if it is diagnosed late, the lung involvement can be extensive, and furthermore, if the antigenic stimulus persists, the response to treatment will be incomplete. We present the clinical case of a 65-year-old patient who had intracapsular rupture of her breast implants approximately 18 months ago, 27 years after their placement. With the same evolution time, she progressively developed dyspnea, dry cough and under mammary pain, having reached the diagnosis of diffuse bilateral organizing pneumonia, associated with implant rupture.
Assuntos
Humanos , Feminino , Idoso , Falha de Prótese , Implantes de Mama/efeitos adversos , Pneumonia em Organização/etiologia , Ruptura , Silicones , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Pneumonia em Organização/terapia , Pneumonia em Organização/diagnóstico por imagemRESUMO
La neumonía por COVID-19 genera tanto daños inmediatos por efecto viral como alejados por desregulación inmunológica inflamatoria. La corticoterapia sistémica ha demostrado ser beneficiosa en la primer parte del proceso, pero aún se desconoce con certeza su utilidad en el daño post agudo. El número de pacientes afectados hace imperativo encontrar terapéuticas que reduzcan las potenciales secuelas pulmonares. Se incluyeron en esta serie de casos 18 pacientes internados en instituciones médicas privadas polivalentes de la Ciudad de Buenos Aires: 15 de sexo masculino y 3 femenino y edad 58,4 ± 13,6 años. Antecedentes comórbidos más frecuentes: HTA (4 pacientes), obesidad (6 pacientes) y tabaquismo (4 pacientes). Cinco pacientes no presentaban ningún antecedente médico. Todos los incluidos presentaron disnea, desaturación de oxígeno y alteraciones tomográficas persistentes o en progresión, posteriores a los 14 días de su infección. Todos recibieron dexametasona acorde a las normativas vigentes. Posteriormente, dada la mala evolución, fueron tratados con corticoesteroides orales y/o endovenosos aplicando el tratamiento utilizado para neumonía organizada (OP) secundaria. En 6 de los pacientes se realizó biopsia transbronquial describiéndose patrón OP en 3 de ellos. Cuatro semanas después de iniciado dicho tratamiento todos los pacientes presentaron mejoría clínica expresada por menor disnea, ningún paciente mantuvo el requerimiento de oxígeno y todas las tomografías de tórax mostraron clara disminución de la afectación parenquimatosa pulmonar. Los corticoides sistémicos administrados en el periodo post agudo de la COVID-19 tienen un efecto beneficioso clínico y radiológico.
Assuntos
Pneumonia , Corticosteroides , COVID-19 , Pneumonia em OrganizaçãoRESUMO
Abstract COVID-19 pneumonia generates both immediate damage due to the viral effects and distant damage due to inflammatory immune deregulation. Systemic corticosteroid therapy has proven to be beneficial in the first part of the process, but its usefulness in post-acute damage is still unclear. The number of affected patients makes it imperative to find a treatment that reduces potential pulmonary sequelae. This series of cases included 18 patients admitted to polyvalent private medical institutions of Buenos Aires City: 15 were male and 3 were female; age 58.4 ± 13.6 years. History of most common comorbidities: AHT (4 patients), obesity (6 patients) and smoking (4 patients). Five patients had no medical history. All patients showed dyspnea, oxygen desaturation, and persistent or progressive tomo graphic abnormalities 14 days after their infection. All of them received dexamethasone according to current regulations. Subsequently, given the poor evolution, they were administered oral and/or intravenous corticosteroids with the same treatment used for secondary organizing pneumonia (OP). A transbronchial biopsy was performed in 6 of the patients, showing an OP pattern in 3 of them. Four weeks after the beginning of the treatment, all of the patients showed clinical improvement expressed by decreased dyspnea and the fact that they didn't require oxygen anymore and that all chest tomographies showed clearly reduced pulmonary parenchymal involve ment. Systemic corticosteroids administered in the post-acute period of COVID-19 have a clinical and radiological beneficial effect.